Piercing Consent Form (Under 16)

Are you on any prescribed medication, antibiotics or blood thinning medication (e.g. Aspirin)? Required

No

Yes

Have you had any alcohol in the last 24 hours? Required

No

Yes

Do you have any allergies? (Select all that apply) Required

Do you suffer from any of the following skin conditions? (Select all that apply) Required

No

Psoriasis

Eczema

Keloid scarring

Do you suffer from any of the following? (Select all that apply) Required

Have you eaten in the last 2 hours? Required

No

Yes

Do you bruise easily? Required

No

Yes

Are you prone to fainting? Required

No

Yes

PIERCING CONSENT FORM (UNDER 16)